分化型甲状腺癌侵犯喉气管的外科治疗

目的：探讨分化型甲状腺癌（WDTC）侵犯喉气管的手术治疗方法。方法：回顾性分析21例WDTC侵犯喉气管患者的临床资料。根据手术方式的不同,将患者分为肿瘤根治组（A组,5例）、肿瘤易除组（B组,11例）和姑息性切除组（C组,5例）。结果：21例患者的3,5,7年生存率分别为81．0％（17／21）、61．9％（13／21）和42．9％（9／21）。A、B两组的生存率均明显高于C组（P＜0．001,P＜0．03）,A组的5,7年生存率虽高于B组,但差异无显著性（P＞0．05）。结论：多数WDTC侵犯喉气管患者宜采取保守性手术,如肿瘤侵及管腔内,患者出现呼吸困难和呼吸道出血等并发症,则需要采取根治性手术。

Surgical treatment for well-differentiated thyroid carcinoma invading the laryngotrachea

Objective To discuss the method of surgical treatment for well-differentiated thyroid carcinoma (WDTC) invading the laryngotrachea. Methods According to surgical procedure, 21 patients with WDTC invading the laryngotrachea were divided into tumor radical removal group(Group A, n=5), tumor chisel group (Group B, n=11) and tumor debulking group (Group C, n=5). Results The overall 3-, 5- and 7-year survival rates were 81.0%(17/21), 61.9% (13/21) and 42.9% with better result in Group A (P<0.001) and Group B (P<0.03) than in Group C, however, without any significance between Groups A and B (P> 0.05). Conclusion Conservative operation should be considered in most patients with well differentiated thyroid carcinoma invading the laryngotrachea. Only in the presence of intraluminal invasion in the trachea causing hemoptysis and airway obstruction does it require radical operation.